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General NPI Number Information
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NPI Number | 1154120202
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Entity Type | Individual
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Provider Name | FLORA LUCAS MWAGALA
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Gender | Female
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Dates
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Enumeration Date | 03/11/2025
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Last Update Date | 03/11/2025
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Provider Practice Location Address
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Address Line | 701 RAWS AVE
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City | SOMERDALE
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State | NJ
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Zip | 08083-1237
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Country | US
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Telephone | 856-291-0822
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Fax |
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Provider Business Mailing Address
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Address Line | 303 5TH AVE RM 1108
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City | NEW YORK
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State | NY
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Zip | 10016-6655
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Country | US
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Telephone | 212-960-8626
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Fax | 646-774-0376
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State | NY
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